Development and Initial Validation of the Three-Levels-of-Needs Questionnaire for Self-Assessment of Palliative Needs in Patients with Cancer
Development and Initial Validation of the Three-Levels-of-Needs Questionnaire for Self-Assessment of Palliative Needs in Patients with Cancer
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DOI：
10.1016/j.jpainsymman.2010.08.013
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发表时间：
2011-06-01
影响因子：
4.7
通讯作者：
Groenvold, Mogens
中科院分区：
文献类型：
--
作者：
Johnsen, Anna Thit;Petersen, Morten A.;Groenvold, Mogens
上下文为了改善姑息治疗，重要的是问卷准确评估患者的需求。目前还没有一份调查表将三种不同的重要需求评估方法结合起来。我们开发了这样一个问卷，称为三个层次的需求问卷（3LNQ），基于文献检索。作为欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）的补充，3LNQ采用三种不同的方法测量12种重要需求：问题强度、问题负担和感受到的需求。研究3LNQ.Methods的初始效度。我们使用了一种相对较新的方法，调查问卷对患者和研究人员的意义是否相同。为此，74名晚期癌症患者填写了问卷，并参加了一个开放式访谈。将患者在访谈前对问卷的回答与研究人员在访谈基础上的回答进行比较。显示基本一致的项目被视为有效，无需进一步分析。对其余项目进行定性分析。所有项目的问题强度，12个项目的问题负担，和12个项目中的3个项目的需要被认为是有效的，因为高协议。关于其余项目的定性数据的分析表明，大多数分歧并不表明患者的自我评估的问题。相反，不同的原因分歧被阐明，但这些并没有干扰有效性。3LNQ似乎可以全面衡量姑息治疗需求，初步验证结果令人满意。分析提供了重要的见解，病人的看法，他们自己的情况下，到他们的期望的医疗保健系统，并进入复杂的需求评估。J Pain Symptom Manage 2011; 41：1025-1039. (C)2011年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. To improve palliative care, it is important that questionnaires accurately assess the needs of the patients. No questionnaire existed that combined three different and important approaches to needs assessment. We developed such a questionnaire, called the Three-Levels-of-Needs Questionnaire (3LNQ), based on literature searches. The 3LNQ measures 12 important needs with three different approaches when used as a supplement to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): problem intensity, problem burden, and felt need.Objectives. To investigate the initial validity of the 3LNQ.Methods. We used a relatively new method that investigates whether the questionnaire has the same meaning for the patients as for the researchers. To do this, 74 patients with advanced cancer filled out the questionnaire and participated in an open-ended interview. The patients' responses to the questionnaire before the interview were compared against the researchers' responses based on the interviews. Items showing substantial agreement were accepted as valid without further analysis. For the remaining items, reasons for disagreements were analyzed qualitatively.Results. All items on problem intensity, eight of 12 items on problem burden, and three of 12 items on felt need were accepted as valid because of high agreement. Analysis of the qualitative data concerning the remaining items showed that most disagreements did not indicate problems with the patients' self-assessment. Instead, different causes for disagreements were elucidated, but these did not interfere with validity.Conclusion. The 3LNQ appears to measure palliative needs comprehensively, and this initial validation showed satisfactory results. The analysis gave important insights into the patients' perceptions of their own situations, into their expectations of the health care system, and into the complexity of needs assessment. J Pain Symptom Manage 2011; 41: 1025-1039. (C) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.